Mapping of Brain Activations to Rectal Balloon Distension Stimuli in Male Patients with Irritable Bowel Syndrome Using Functional Magnetic Resonance Imaging.

Mapping of Brain Activations to Rectal Balloon Distension Stimuli in Male Patients with Irritable Bowel Syndrome Using Functional Magnetic Resonance Imaging.

J Neurogastroenterol Motil. 2017 Feb 14;:

Authors: Guleria A, Karyampudi A, Singh R, Khetrapal CL, Verma A, Ghoshal UC, Kumar D

Abstract
Background/Aims: Irritable bowel syndrome (IBS) is associated with exaggerated cerebral response including emotional processing following visceral stimulation; though data on this issue is available in female IBS patients, it is scanty among male. Hence, we aimed to study brain response of male IBS patients following rectal balloon distension as compared to healthy controls using functional magnetic resonance imaging (fMRI). Data between diarrhea and constipation predominant IBS (IBS-D and IBS-C) were also compared.
Methods: Rectal balloon distension threshold was assessed in 20 male IBS patients (10 IBS-C and 10 IBS-D) and 10 age-matched male healthy controls. Subsequently, fMRI on all the participants was performed at their respective rectal pain threshold. The fMRI data were analysed using Statistical Parametric Mapping software.
Results: IBS patients showed greater cerebral activations in insula, middle temporal gyrus, and cerebellum in left hemisphere compared to healthy controls. Neural activation was found in bilateral precuneus/superior parietal lobule in controls but not in patients with IBS. The brain activation differed among IBS-C and IBS-D patients; while right mid-cingulate cortex was activated in IBS-C, left inferior orbito-frontal cortex, left calcarine, and bilateral fusiform gyrus were activated among patients with IBS-D following rectal balloon distension.
Conclusions: Brain response to rectal balloon distension differed among male patients with IBS and controls and among patients with IBS-C and IBS-D. Differential activation among patients with IBS-C and IBS-D were seen in the brain regions controlling affective motivation, homeostatic emotions, and autonomic responses to pain.

PMID: 28192648 [PubMed - as supplied by publisher]

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